10 September 2014

Antibiotic-resistant bacteria on household surfaces

Household objects like sheets, towels and TV remotes may be reservoirs for MRSA contamination.


Surfaces in households with children with MRSA infections are often contaminated with the same strain of bacteria, according to new findings.

Contamination was found most frequently on bed linens, TV remote controls, and bathroom hand towels, Dr. Stephanie A. Fritz of Washington University School of Medicine in St. Louis and her colleagues report in JAMA Paediatrics.

MRSA infections

MRSA stands for methicillin-resistant Staphylococcus aureus, a kind of bacteria that can't be controlled by common antibiotics. At one time, MRSA infections were mostly "caught" by hospital patients, but lately people have been acquiring it even outside healthcare settings.

"Household environmental sources are reservoirs of Staphylococcus aureus isolates that cause infection in children," Fritz told Reuters Health.

While the new study could not show whether the children were contaminating these surfaces, or catching the infection from the surfaces, she and her colleagues are conducting a two-year follow-up study that they hope will provide answers.

Read: Germs on your skin may be good for you

Skin and soft tissue infections with MRSA often recur, Fritz and her team note in their report. In an earlier study of theirs, treating household members of a child with MRSA, in a procedure known as "decolonization", reduced recurrence of the infection compared to decolonizing the child only – but during the next year, the infections reoccurred in half of the patients in the study.

Detecting colonisation

To determine whether household surfaces might be a reservoir for infection, the researchers enrolled 50 children with active or recent community-acquired MRSA. They sampled the nostrils, armpits and groin of each child to detect colonization, as well as 21 household surfaces and pet dogs and cats. All identified strains were typed to identify relatedness within households.

Read: Which germs lurk in your home?

The researchers found MRSA in 23 of the 50 households, with the most frequently contaminated surfaces being bed linens (18 percent), TV remotes (16 percent), and bathroom hand towels (15 percent). Twelve percent of dogs and 7 percent of cats also were colonized with MRSA.

In 20 households, the researchers identified at least one surface contaminated with the same strain as that isolated from the patient.

Does cleaning make a difference?

Cleaning frequency was not associated with the likelihood of finding S. aureus on household surfaces, but Dr. Fritz noted that study participants may not have responded accurately to questions about cleaning frequency, and also were not asked which cleaning products they used.

Read: The dangers of not washing your hands

"These environments do likely play a role in the transmission between the household members, and may play a role in the development of infection," Fritz said. It's not clear, though, she added, whether "targeted cleaning" of those surfaces will decrease the spread of infection.

In an editorial published with the study, Dr. Aaron Milstone of Johns Hopkins Children's Centre in Baltimore wrote that about 30 percent of children who develop skin and soft tissue infections with MRSA have recurrence of the infection, he told Reuters Health.

What can be done?

The findings "show that there's a clear link between what people have and what's in their environment," he said. "The big question is can we improve that, is cleaning really going to make a difference in the long term? I do applaud them for chipping away at this, because it's a big public health problem. I look forward to the next steps."

Read: Pets may pass on illnesses to owners

"What I would say to my patients, which is a simple message, is it's not going to hurt to clean your house. We don't know yet if that's going to prevent the problem," he added. "This study doesn't show that if people clean their houses compulsively and fanatically the problem is going to go away."

The findings do show, he added, that pets are not likely to be an important reservoir of MRSA. "Don't get rid of your dog in an attempt to cure this."

Read more:

Cupboards – problems & solutions
Germs lurk in unexpected places
The sponge – problems & solutions

Image: MRSA bacteria from Shutterstock

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